Giant Abdominal Neuroblastoma in an Infant with Dilated Cardiomyopathy: An Intraoperative Challenge

  • Bhavna Gupta Departmentof Anaesthesia, AIIMS, Rishikesh, India
  • Anju Romina Balhotra Maulana Azad Medical College, New Delhi, India
Keywords: Anaesthetic management, Dilated cardiomyopathy, Neuroblastoma, Severe left ventricular systolic dysfunction


Neuroblastomas are cancers that originate from neuroblasts and are found most commonly in infants. An association of neuroblastoma with dilated cardiomyopathy in an infant is rare and we report the successful perioperative management of a five-month-old baby with giant abdominal neuroblastoma and severe left ventricular systolic dysfunction. Our patient had a cardiac arrest during bone marrow aspiration and complexity of anaesthesia was determined by the large tumour mass compromising the respiration, increased intraabdominal pressure and cardiomyopathy with severe left ventricular dysfunction owing to effects of both chemotherapy and post cardio-respiratory arrest. Care of such patients is complicated by the fact that they have differing anaesthesia management goals, aiming at maintaining the patient’s hemodynamic variables of preload, heart rate, contractility and afterload, while also simultaneously maintaining respiratory parameters.


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Author Biographies

Bhavna Gupta, Departmentof Anaesthesia, AIIMS, Rishikesh, India

Assistant Professor


Anju Romina Balhotra, Maulana Azad Medical College, New Delhi, India

Director Professor


Cohn SL, Pearson AD, London WB, Monclair T, Ambros PF, Brodeur GM, et al. The International Neuroblastoma Risk Group (INRG) Classification System: An INRG task force report. J Clin Oncol. 2009; 27:289–97.

Hammer G, Hall S, Davis PJ. Anesthesia for general abdominal, thoracic, urologic and bariatric surgery. Neuroblastoma procedures. In: Smith’s anesthesia for infants and children. 8th ed. Edited by Motoyama EK, Davis PJ, Cladis FP: Philadelphia, Elsevier Mosby Publishers. 2011, 754-5.

Nugent AW, Daubeney PE, Chondros P, Carlin JB, Cheung M, Wilkinson LC, et al. The epidemiology of childhood cardiomyopathy in Australia. N Engl J Med. 2003; 348: 1639–46.

Popescu WM. Heart failure and cardiomyopathies. In: Stoelting’s Anesthesia and co-existing disease. 6th ed. Edited by Hines RL, Marschall KE: Philadelphia, Elsevier saunders publishers. 2012, 121-40.

Stevenson LW, Perloff JK. The Dilated cardiomyopathy: clinical aspects. Cardiol Clin 1988; 6: 187–218.

How to Cite
Gupta B, Balhotra A. Giant Abdominal Neuroblastoma in an Infant with Dilated Cardiomyopathy: An Intraoperative Challenge. APSP J Case Rep [Internet]. 19May2019 [cited 18Apr.2021];9(4):24. Available from: